Brent Hayden, M.D.,P.a.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BRENT HAYDEN, M.D.,P.A.

Practice address

733 SW State Road 47
Lake City, FL 32025-0453

Phone

(386) 755-0645

Fax

(386) 961-9541

NPI assigned

Oct 5, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Donald Brent Hayden, M.D.NPI 1013061456

Title

President

Phone

(386) 755-0645

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Donald Brent Hayden, MD

  • General Practice Physician
  • Lake City, FL
  • NPI 1013061456
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1326373606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 SW STATE ROAD 47",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250453",
            "telephone_number": "386-755-0645",
            "fax_number": "386-961-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 SW STATE ROAD 47",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250453",
            "telephone_number": "386-755-0645",
            "fax_number": "386-961-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT HAYDEN, M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-05",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "HAYDEN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-755-0645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE NUMBER",
            "identifier": "ME0043394",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "12066",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041891900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathi Bracewell
• Jalise Bradley
• Shakeena Denise Brantley, LCSW
• Delilah Bray
• Tiffany J Brazeal
• Brenda J Brickel
• Kristian Danielle Brinson
• Joanna Dee Brittain, COTA/L
• Barry Brody, PH.D.
• Annie B Brooks, CMSW

• General Practice Physician in Lake City, FL
• Providers in Lake City, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.